Avoiding unnecessary care: Does insurance coverage matter?

Consumer Reports‘ “Choosing Wisely” initiative aims to identify high-cost, low-value treatments that can often be avoided.  One question remains is why do providers still offer these services?  Do payer coverage policies or reimbursement rules affect these choices? A paper by Colla et al. (2017) attempts to answer that question.  The authors used commercial payer claims data…

Physician Prescribing Recommendations for Themselves and for Patients

In one of my recent publications, I show that patient and physician risk preferences differ.  Patients are willing to take take treatments with more both upside and downside risk, whereas physician prescribe treatments large based on which one provides the most efficacy to the average patient. One question that remains is how do patients and physician preferences over treatments…

Patient and Physician Risk Preferences

Physicians are supposed to act as agents for patients, acting in their best interest. But a question is, how well do physician know patient preferences? How well do physician preferences reflect those of patients. Previous research indicates that for terminal diseases, patients are risk loving. My own recently published research (with co-authors Schwartz, Okoro and…

“You can’t fix by analysis what you bungled by design”

This is a quote from Light, Singer, and Willet (1990) and is mentioned on a recent commentary by Stephen B. Soumerai  and Ross Koppel in Health Services Research. The commentary focuses on the use of instrumental variables when conducting health care effectiveness reserach.  They define instrumental variables concisely as: An instrumental variable (IV) is a variable, generally found in…

Innovations in Cancer Care: Capturing What Patients Value in the Calculus of Drug Costs

My current employer, Precision Health Economics, has posted an interesting research brief describing how traditional notions of value may not be capturing the full value patients receive from oncology treatments. A brief description is below but do check out the full report. As health care spending continues to rise, payers and providers struggle to accurately measure…

Special Issue on Value Assessment Frameworks

Value in Health has a Special Issue on Value Assessment Frameworks.   The issue includes one of my papers (co-authored with Taylor T. Schwartz, Tony Okoro, John A. Romley) titled Patient Versus Physician Valuation of Durable Survival Gains: Implications for Value Framework Assessments.  The abstract is below.   Background: Previous research indicates that patients value therapies that provide…